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Intraoperative mechanical and chemical pleurodesis with 50 % glucose solution for secondary spontaneous pneumothorax in patients with pulmonary emphysema

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Abstract

Purpose

Secondary spontaneous pneumothorax is life-threatening for patients with pulmonary emphysema. To prevent recurrence, intraoperative pleurodesis is performed in addition to bullectomy. We report the therapeutic process and effectiveness of adding mechanical plus chemical pleurodesis, with a 50 % glucose solution, to bullectomy, for patients with pulmonary emphysema-related pneumothorax.

Methods

The subjects were 20 patients (19 men and 1 woman; mean age 68 years) with pulmonary emphysema-related pneumothorax. After bullectomy was completed, 500 mL of a 50 % glucose solution was injected into the pleural cavity, followed by mechanical pleurodesis performed via ablation of the parietal pleura.

Results

The volume of pleural effusion decreased on postoperative day (POD) 1, and the temperature decreased on POD 2. The blood sugar levels increased on the day of surgery but decreased on POD 1. The mean postoperative follow-up period was 521 days. One patient died of pneumonia on POD 24. All other patients survived without pneumothorax recurrence.

Conclusions

These results demonstrated the effectiveness of our treatment process for pulmonary emphysema-related pneumothorax. The fact that no patient experienced pneumothorax recurrence suggests that mechanical and chemical pleurodesis with 50 % glucose solution might be effective prophylaxis.

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Abbreviations

FGF:

Fibroblast growth factor

HJ:

Hugh-Jones classification

PS:

Performance status

VATS:

Video-assisted thoracic surgery

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Conflict of interest

The authors of this manuscript have no relevant financial or other potential conflict of interest.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Bell Land General Hospital, 500-3 Higashiyama, Naka-ku, Sakai, 599-8247, Japan

    Takuma Tsukioka, Kiyotoshi Inoue & Hiroko Oka

  2. Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan

    Shinjiro Mizuguchi, Ryuhei Morita & Noritoshi Nishiyama

Authors
  1. Takuma Tsukioka
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  2. Kiyotoshi Inoue
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  3. Hiroko Oka
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  4. Shinjiro Mizuguchi
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  5. Ryuhei Morita
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  6. Noritoshi Nishiyama
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Corresponding author

Correspondence to Takuma Tsukioka.

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Tsukioka, T., Inoue, K., Oka, H. et al. Intraoperative mechanical and chemical pleurodesis with 50 % glucose solution for secondary spontaneous pneumothorax in patients with pulmonary emphysema. Surg Today 43, 889–893 (2013). https://doi.org/10.1007/s00595-013-0497-5

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  • DOI: https://doi.org/10.1007/s00595-013-0497-5

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